The overall objective of this longitudinal study is to explore communication and decision-making with patients who have recurrent breast cancer. The long-term goals of this line of research are to determine patients' communication needs throughout the continuum of breast cancer care and to develop patient education programs that provide information at the appropriate time, from initial diagnosis to palliative care. This study focuses specifically on the health communication needs and the process of treatment decision-making among patients with recurrent breast cancer, a priority research area within the NCI. The specific aims are to: 1) Examine information exchange and decision-making during the first two medical encounters with the medical oncologist following clinical confirmation of recurrent breast cancer, focusing on: 1) information about the patient's diagnosis and prognosis; 2) decisions about treatment options; 2): Determine health communication needs and perspectives on treatment decision-making for 4 months following patients' diagnosis of recurrent breast cancer. These aims will be achieved by video recording patient-medical oncologist visits after a diagnosis of recurrent breast cancer has been confirmed and conducting a longitudinal set of semi-structured interviews with patients and family members, and a single interview with healthcare providers. We will include patients with local or systemic recurrence in order to determine the extent to which health communication needs differ within the population of patients with recurrent disease. This research is innovative in that it combines observations of the patient-physician encounter with a longitudinal series of interviews of patients with recurrent breast cancer, as well as their family members, and includes perspectives of healthcare providers. After the successful completion of this study, our goal will be to apply this knowledge to the development and testing of education and counseling tools for patients with recurrent breast cancer, for their families, and for the providers who serve them. [unreadable] [unreadable] [unreadable]